More strategies may have a better effect than one. Many ways to manage migraine.

Migraine Awareness Month, June 2024

The theme this year for Migraine Awareness Month is ‘stronger together’. 

Migraine Australia focus on how we are stronger when we have support, share our stories and strategies, and work together as a community. They understand different people have different ways of comfortably connecting with others, and in this respect they have a variety of initiatives planned for this month, including: Burple Day; launching new community support groups; a community quilting project; and a social #shadesformigraine awareness campaign.

Effective treatments for migraine may also be ‘stronger together’. 

Indeed, for most, a holistic approach and a combination of treatment options may work best. A migraine experience is complex and differs between individuals, so the combination of effective treatments and strategies that work for each individual will differ too. 

Photo by JOSHUA COLEMAN on Unsplash

You might build on your preferred combination of helpful options, when it comes to your migraine, among these:

PEER SUPPORT

Is it true that ‘two (or more) heads can be better than one’? 

When it comes to migraine, you are not alone. Migraine is one of the top ten most disabling conditions in adults worldwide. That’s a lot of people enduring migraine, people you may not know because of the known stigma that surrounds migraine. Awareness months like this act to shift and remove the power of this stigma. The real help for a unique individual that can come from: peer validation and acknowledgement; peer discussion; direct social and emotional support; and in the age of technology - social media - is becoming more broadly respected. So too the positive science of why turning to peers as an integral part of managing chronic conditions is becoming more deeply understood. 

COOL WATER

Last year a meta-analysis of scientific literature (a meta-analysis is where an experienced research team look very closely at as many published studies about the same topic that they can find from around the world) was completed investigating the effectiveness of cold treatments on relieving migraine symptoms. It reveals, that compared to non-cold regimens, cold interventions - things like cold gel headbands, skin temperature biofeedback, and cool wraps - have a measurable short-term, even instant, effect on reducing migraine pain. 

Hydration may seem too simple, we may even be casually offhand and dismiss this recommendation because of its common simplicity, but the ways water works in our bodies when it comes to headache pain is actually very interesting. Before discussing this further we acknowledge migraine is much more than a headache, but the ways water works in these experiences have similarities. When we improve hydration in migraine we can balance all the different parts of our plasma (our liquidness) and electrolytes. When we restore hydration in the brain, we can minimise what can be the negative effects of dehydration on our pain-sensitive linings of our brain and blood vessels. Water intake can reduce the severity of a migraine and reduce the intensity and duration of a headache. 

Photo by Daniel Lincoln on Unsplash

QEEG directed NEUROFEEDBACK

How your brain behaves when it comes to migraine pain is not stuck or fixed, it is plastic - which means it works by changing. Your brain, at any age, is changing all the time. It is changing with everything you think, feel, and do every moment of every day. 

Neurofeedback Therapy, also known as EEG Biofeedback, is a brain-based treatment that uses a sophisticated brain-computer interface to ‘strengthen’ or ‘rewire’ the brain, by training and changing brainwaves, the tiny electrical signals produced by the brain. Targeted, specific and personalised Neurofeedback Therapy is guided by special brain scans known as QEEG (Quantitative Electro-Encephalogram). 

Neurofeedback is a drug free treatment that is not just an efficacious treatment for headache, but also for anxiety and depression that individuals with migraine may also experience.

BIOFEEDBACK

There is a brain body connection that wanders all the way through you. Vagus, in Latin means ‘wandering’. The vagus nerve is the longest and most complex cranial nerve. HRV Biofeedback has been emotively coined ‘the hearts eye to the vagus’ in an article from 2022 in the Journal of Clinical Medicine.  Biofeedback training teaches you how to rebalance your body and brain by showing you how your own nervous system is working. Biofeedback technology has been developed over more than 60 years. Over this time a lot of research has been done into its effectiveness as a treatment specifically for migraine.

Photo by Priyanka Singh on Unsplash

tDCS

Non-drug and non-invasive brain-based treatments for migraine can now include tDCS (or Trans-Cranial Direct Current Stimulation). tDCS uses a small and safe direct current applied to the outside of the head to gently stimulate the brain. tDCS may already be known to you as a safe and drug-free treatment for depression after the published studies conducted by The Black Dog Institute, but research also shows that tDCS can be helpful for people with migraine as well. A recent research study showed significant reduction in the experience of monthly migraine in the group that was engaged in tDCS treatment.

DIET & NUTRACEUTICALS

Those suffering with migraines have probably been asked a lot if they have any ‘trigger’ foods, these can include anything from chocolate to even an apple. It’s interesting to know it is some of the tiny little things that might be in these foods that could be the culprits contributing to a migraine, things like: nitrates; sulphates; tannins and some amino-acids. 

New studies are emerging looking closely at diet and migraine. In an article discussing migraine and lifestyle factors in Frontiers in Neurology authors highlight that diets higher in anti-inflammatory omega-3 fatty acids, and lower in pro-inflammatory omega-6 fatty acids, can reduce the duration and frequency of migraine. Generally a good place to start, when looking at diet and brain health, is the Mediterranean and MIND Diets. Both diets, interestingly, emphasise plant-based foods cooked from scratch.

Photo by Antonino Visalli on Unsplash

STRESS MANAGEMENT

The way an individual manages stress day-to-day, and the strategies that work for them, are unique. In a general sense we can help our brains and bodies manage stress by:

• Getting enough good quality sleep.

• Prioritising finding a style of exercise that suits our bodies and doing it at least a few times each week.

• Finding a mindfulness technique, meditative practice, or breathing exercises that we can comfortably repeat that brings us a sense of calm or relaxation.

• Listening to music we enjoy 

• Spending time with friends and family

• Getting lost in a good book

• Spending time in nature
  
  

All of this knowledge, and a great deal more, has helped to build a range of practical treatments for migraine. The skilled Clinicians at Perth Brain Centre are equipped to teach you how these brain exercises for pain work and how to incorporate them into your daily life, to reclaim your brain and your life from chronic or persistent migraine pain experiences. There are three easy steps to help get you started today.

About the author - Ms. Emily Goss (Occupational Therapist, Senior Clinician, The Perth Brain Centre).